[show abstract][hide abstract] ABSTRACT: BACKGROUND: The applicability of different definitions of metabolic syndrome (MetS) in predicting cardiovascular diseases (CVD) remains questionable. The aim of this study was to compare predictive ability of different definitions of MetS for CVD in non-diabetic subjects. METHODS: In this community-based study, 5198 non-diabetic subjects aged≥30years (mean age 45.6years, 45% men) free of CVD at baseline were followed for a median of 9.3years to assess risk for CVD. We assessed the predictability of definitions of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), the International Diabetes Federation (IDF), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), and the joint interim statement (JIS) on development of CVD. Hazard ratios (HRs) were calculated using Cox proportional-hazards models. The receiver operating characteristic (ROC) curve was also used to compare discriminative power of these MetS definitions in predicting CVD events. RESULTS: Compared to other definitions, the JIS identified more participants (41.8%) having MetS. First CVD events occurred in 311 subjects. After adjustment for potential confounders, the HRs of the NCEP-ATP III, AHA/NHLBI, IDF and JIS definitions for incident CVD were 1.55 (1.21-2.00), 1.73 (1.35-2.20), 1.54 (1.22-1.94) and 1.70 (1.34-2.17), respectively. All definitions showed higher HRs for females in comparison to males (P<0.05). ROC analysis showed no significant difference in the discriminative power of different MetS definitions in predicting CVD events (P>0.05). CONCLUSIONS: In the current study, compared to each other none of the definitions showed a superior discriminative power in predicting CVD; although, all definitions were more predictive in females than in males.
International journal of cardiology 10/2012; · 7.08 Impact Factor
[show abstract][hide abstract] ABSTRACT: Chronic kidney disease(CKD) has been proposed as a risk factor for cardiovascular disease (CVD). There is conflicting evidence among community based studies regarding the association between CKD and CVD. Furthermore, in order to assess the possible interaction between CKD and BMI, we also examined the association between CKD and CVD, across different BMI categories.
The risk of CVD events was evaluated in a large cohort of participants selected from the Tehran Lipid and Glucose Study. Participants(mean age, 47.4 years) free of previous CVD were followed up for 9.1 years. GFR ml/min per 1.73 m(2) was estimated using the MDRD formula.
Of the 6,209 participants, 22.2%(1381) had CKD with eGFR ml/min per 1.73 m(2) <60 at baseline. Almost all of them (99%) were in stage 3a. Moderate renal insufficiency only predicted CVD outcomes independently when we adjusted for age and sex. After further adjustment, the presence of moderate CKD lost its statistical significance to confer an independent increased risk of CVD events with a hazard ratio of: HR: 1.14, CI 95% 0.91-1.42. Furthermore, when participants were categorized according to CKD status and BMI groups, after further adjustment, no interaction was found(P = 0.2).
CKD was not an independent risk factor for CVD events in a community-based study in a Tehranian population and the higher prevalence of CVD in subjects with mild to moderate renal insufficiency might be due to the co-occurrence of traditional CVD risk factors in this group.